Why is brushing children's teeth so important?
Many people think brushing a child's milk teeth is not that important as they are going to fall out anyway. However, this is a fallacy. In fact, correct brushing is especially important for children. Milk teeth provide the perfect environment for bacteria to cause dental caries. Since the enamel is only about half as thick as that on adult teeth, bacteria can colonise and swiftly penetrate the interior of the tooth – potentially resulting in severe pain.
According to the dental report by Barmer, one of the leading German health insurances, dental caries is widespread among young children: More than half of all ten-year-olds have already experienced some form of dental caries. And this figure could be even higher, seeing as more than 15 percent of six-year-olds have never been to the dentist.
But what actually happens if children do not brush their teeth? Are they not given a fresh start when their adult teeth start coming through? Unfortunately not. If their milk teeth suffer decay, the bacteria automatically spreads to their new adult teeth. Quite often their permanent teeth are already infected by the time they erupt and your child faces a lifetime of dental problems. However, this can be easily avoided by ensuring their teeth are brushed correctly right from the start. If you make sure that your child brushes their teeth correctly, it will help to support and sustain life-long dental health. Because: A clean tooth cannot get sick.
Further, essential habits and beliefs take root between the ages of four and twelve, serving as the basis for all future decisions in life. In other words, if you teach your child early on that they need to brush their teeth daily – without fail – they are more likely to go through life with a high awareness of healthy living and make better choices – for example, in terms of their diet and other lifestyle habits.
Good to know:
Did you know that dental caries can be transmitted from one individual to another. If you place a spoon, dummy or drinking bottle in your mouth before giving it to your child, there is a risk of transmitting cavity-causing bacteria to your child's mouth. And the bacteria then spread swiftly on milk teeth, which are particularly vulnerable to decay.
By the way: Diet and dental caries
Cavity-causing bacteria require sugar to create the acids that are harmful to tooth enamel. That said, even if your child rarely or never eats sweets, they still need to brush their teeth daily. Cavity-causing bacteria also thrive on fructose, lactose and glucose, which are also found in healthy foods such as fruit and yoghurt. By the way, completely eliminating sugar from your child's diet is probably not the best plan either, as this only makes sweets and sugary treats more attractive. If your child brushes their teeth daily and properly, they can also enjoy an occasional treat like a piece of cake or a small bar of chocolate.
Everything you need to know about brushing children's teeth correctly
How do you brush a young child's teeth? And when can your child start brushing on their own? Find answers to the most frequently asked questions here:
Brushing young children's teeth: When should you start?
It is a good idea to start brushing as soon as the first tooth erupts. Correct oral and dental care begins with the very first tooth, i.e. when your child is about six months old. This is the ideal time to get your child used to brushing their teeth regularly. Simply take a super-soft baby toothbrush and some children's toothpaste or a piece of damp cloth wrapped around your finger and brush their tiny teeth and gums.
Good to know:
The filaments of the Curaprox baby toothbrush are extra-fine and gentle so as not to harm the delicate oral mucosa of babies. Moreover, the brush head is rubberised. A big bonus: The toothbrush is free from harmful substances such as bisphenol A (BPA), phthalates or azo dyes and therefore completely safe – even if your toddler decides to use it as a teething ring.
How do you brush a young child's teeth?
If your child is under 12 months old, sit them on your lap with the back of their head resting against the crook of your arm or lay them on a changing table. You can also brush their teeth properly with them lying or sitting on the floor. Later, when they are a little older and can stand on their own, it is best if they stand in front of you with their head tilted back slightly, allowing you to reach all their teeth with ease. Make small, gentle, circular movements around all the teeth, remembering to also brush the chewing surface of each tooth.
Expert tip: Wear a headlamp to illuminate the dark oral cavity and to see exactly how and where you are brushing.
At around age two or three, let your child have a go at brushing their own teeth. Now is the perfect time to show your child how to brush their teeth correctly. Place a mirror at eye level to allow your child to see whether they are brushing their teeth properly. Now it is all about being patient. Two-year-olds do not yet have the fine motor skills needed for brushing their teeth correctly and do not really understand why they need to brush their teeth at all. Lovingly support your child, but remember consistency is the key. At this age, it is all about developing good dental habits in a playful manner and not about ensuring the perfect unaided brushing technique.
Remember, you are still responsible for making sure their teeth are clean. Once your toddler has finished brushing, follow up to make sure those difficult-to-reach areas, such as the gumline, the inner surfaces and the back molars, have been cleaned. This usually takes about 30 seconds, but you can, of course, brush for longer if you want.
Good to know:
Teat bottles containing fruit juices, sweetened teas or milk products are particularly dangerous for young milk teeth. Since cavity-causing bacteria convert the sugar into acid that attacks the soft tiny teeth. If your child constantly sucks on a bottle, the delicate enamel has little chance to recover and is permanently exposed to an acid attack. In this case, even regular brushing will not be enough to protect their teeth.
When can children start to brush on their own?
You might be asking for how long you have to follow up and at what age your child can start brushing their teeth unsupervised. In general: It is not until late primary school age that children have developed the fine motor skills needed for toothbrushing.
Your child is usually ready to brush their teeth unsupervised when they are able to do joined-up handwriting with ease. Until then, you should follow up every time they brush their teeth – especially right before bedtime. However, we recommend supervising your child with their brushing until they are nine years old and to constantly promote and encourage good dental hygiene. It is also essential that parents set a good example and brush their own teeth at least twice a day, without exception.
Once your child reaches puberty, they have the dexterity that correct toothbrushing needs, but they often show a lack of desire and motivation to do so. Therefore, as a parent, it is your job to check as often as possible that your child is brushing their teeth correctly and to also explain to them what happens if they clean their teeth half-heartedly or not at all. At this age, children are able to understand the consequences of their actions and that correct brushing is important for the future.
How long and how often should children brush their teeth?
Many parents ask: How long should children brush their teeth? And how often? The answer is simple: Three times a day for three minutes each time. It is best if your child brushes their teeth first thing in the morning, at lunchtime, roughly 30 minutes after eating, and in the evening straight before going to bed. The easiest way to get children to regularly brush their teeth is by turning brushing time into a group activity that the whole family can do together.
Good to know:
As soon as the first milk tooth starts to wobble: Pay even more attention to oral and dental care! Erupting permanent teeth are particularly susceptible to dental caries. As it takes at least three years for the enamel to develop fully.
How do children learn to brush their teeth correctly?
Learning to clean your teeth begins at home, not in school. Children tend to imitate what their parents do. Ideally, you have been brushing your child's teeth since their first tooth erupted and they are completely familiar with this daily routine. With children, it is particularly important to follow a certain sequence when brushing their teeth to ensure no spots are missed or forgotten.
Brushing teeth with the KAI technique
In German-speaking countries, dentists recommend employing a technique known as KAI when brushing children's teeth. This refers to firstly brushing the chewing surfaces, then the outer surfaces and finally the inner surfaces. This toothbrushing technique is particularly popular as it is easy to learn and can, therefore, usually be mastered by young children without any difficulties.
Toothbrushing sequence using the KAI method
- Firstly, your child brushes the chewing surfaces with simple back and forth movements.
- Your child then cleans the outer surfaces with circular movements. Their teeth are closed when brushing.
- And finally, your child focuses on the inner surfaces with rotating movements from red to white (in other words from gums to teeth).
If you want to teach your child how to brush their teeth properly, do it for them, carefully explaining each step as you go. This makes correct toothbrushing a very tangible experience for your child. Now it is your child's turn. Be patient and give them time to get used to holding a toothbrush. A task that adults take for granted is actually a pretty demanding process for the small hands of an infant.
Important: As soon as all their milk teeth are through, your child should also learn to clean the spaces between their teeth once a day with an interdental brush.
Toothbrushing is a trial-and-error process
When it comes to brushing their teeth, your child's level of success may vary considerably from day to day: The toothbrush might become stuck, they are unable to reach the molars, they bite on the brush head or they suddenly squeeze half a tube of toothpaste all over the toothbrush. At times, this can really test the patience of their parents, but remember it is all part of the learning process and completely normal.
Give your child enough space to learn how to brush their teeth and do not intervene immediately if you see that things are not going quite to plan. After all, practice makes perfect. If after a while you realise that your child is struggling unaided, you can provide some helpful advice or follow up to make sure all the surfaces have been cleaned.
When correcting the position of your child's toothbrush or brushing movements, it is best to stand behind them with a mirror in front of you both to show them how to brush their teeth properly. This enables your child to imitate the movements directly without being confused by their mirror reflection.
Follow up: Brushing children's teeth is a team effort
The KAI toothbrushing technique is easy to learn and therefore ideally suited for children. In terms of thoroughness, however, your child still needs a helping hand. It will not be until around the age of seven to nine years that your child has developed the fine motor skills needed to reach every corner of their oral cavity with circular movements. This is why you should follow up at least once a day (preferably before bedtime) to make sure all the surfaces of your child's teeth have been cleaned correctly. Place the toothbrush at a 45-degree angle where the teeth meet the gums and clean the gumline and the teeth gently yet thoroughly with small circular movements.
The correct brushing technique for schoolchildren, teenagers and adults
At around the age of nine years, children can say bye bye to the KAI method and start brushing their teeth like an adult. The most scientifically-backed effective toothbrushing technique for removing plaque is the modified Bass technique – named after Charles Cassidy Bass, the father of preventative dentistry.
Instructions for correct toothbrushing for older children according to the modified Bass technique
Gentle and thorough are the two most important words when it comes to correct toothbrushing for both children and adults. How to clean children's teeth correctly:
- Your child starts off by rinsing their mouth with warm water to loosen any food debris.
- Then they squeeze a pea-sized amount of fluoride toothpaste onto their toothbrush.
- Together with your child, position the toothbrush correctly in their mouth. It should be at a 45-degree angle where the teeth meet the gums (at an upward sloping angle in the upper jaw and a downward sloping angle in the lower jaw).
- Now your child starts brushing the inner surfaces of the lower row of teeth and uses small, circular movements to clean each tooth from the last molar on one side to the last molar on the other side – gently and with very little pressure.
- Change sides: Now clean the outer surfaces of the same row. This is also done using small, circular movements.
- Finally, it is time for the chewing surfaces. Again, your child employs small, circular movements to clean the molars.
- Your child should now repeat the whole process on the upper row of teeth.
- And remember, your child should also clean the spaces between their teeth once a day with an interdental brush.
Tip: To reach the inner surfaces and the back molars properly, your child needs to hold their toothbrush vertically.
Testing with plaque finder tablets: Is everything clean?
If your child is too old for you to follow up, they will definitely no longer want you to brush their teeth. In this case, plaque finder tablets are a great way to check how thoroughly your child is actually brushing their teeth. After a quick chew, these tablets reveal plaque on the teeth, clearly showing both you and your child where extra brushing is needed. This visual evidence is often way more effective than a telling off and encourages youngsters to have less coloured spots of plaque in their mouth next time.
The right toothbrush for children
The ideal children's toothbrush should have soft filaments and a small brush head to avoid injuring a child's delicate gums. Hard filaments and large brush heads tend to make brushing children's teeth a less pleasant experience. The consequence: Your child is in pain and refuses to have their teeth brushed. Therefore, a special children's toothbrush is the better choice. Besides having an extra small brush head and super soft filaments, children's toothbrushes also come with a non-slip handle.
Good to know:
If your child is allowed to pick their own toothbrush, there is more chance of them using it to brush their teeth regularly. Besides being free of harmful substances and cleaning children's sensitive teeth thoroughly and gently with its 5,500 super-soft filaments, the Curaprox kids toothbrush also comes in a range of six bright colours. Your child is bound to find their favourite colour among them. Insider tip: Turn your child's toothbrush into a craft project and let them decorate it with stickers or colourful adhesive tape. This way, toothbrushing becomes even more fun.
Interdental brushes for those spaces between teeth
Teeth actually have five sides, not just three (inner, outer and top surface). In fact, the outer lateral surfaces of the teeth are often completely overlooked. However, bacteria love to colonise the spaces between teeth. It is therefore essential to regularly clean these interdental spaces as part of a thorough oral hygiene routine – even for children. After all, their milk teeth and freshly erupted permanent teeth are particularly susceptible to dental caries. The best idea is to clean the spaces between their teeth once a day with an interdental brush as soon as the milk teeth are through.
Fluoride against dental caries
Have you ever stood in the toothpaste section of a supermarket or pharmacy and asked yourself the following question? "Which toothpaste is best for children?" One thing in advance: There are big differences in quality when it comes to children's toothpaste. Besides being mild, free of harmful substances and effective, a good children's toothpaste should also contain fluoride to strengthen the enamel and protect against dental caries. We recommend the following values – based on guidance provided by the European Academy of Paediatric Dentistry (EAPD):
- Young children, from first tooth to two years: Twice a day, a rice grain-sized amount of children's toothpaste with a fluoride concentration of up to 1,000 parts per million (ppm) – for example Curaprox kids toothpaste with strawberry flavour
- Children from two to six years: Three times a day, a pea-sized amount of fluoride children's toothpaste (up to 1,000 ppm)
- Children above six years: Three times a day, a pea-sized amount of fluoride children's toothpaste (up to 1,500 ppm) – for example Curaprox kids toothpaste with watermelon flavour
Besides providing reliable and lasting enamel protection, children's toothpaste should also be fun and taste good. The typical mint flavour of adult toothpaste is usually too strong and somewhat unpleasant for young children.
But if the toothpaste tastes nice, they will definitely have more fun brushing their teeth. However, if your child wants to brush their teeth with a mint flavoured toothpaste, just like a grown-up, a kids toothpaste with mint flavour is the ideal choice. It has a mild, minty flavour and is enjoyable for children.
When can children start using toothpaste?
You can start brushing with toothpaste as soon as your child's first milk tooth appears – the EADP recommends using a rice grain-sized amount of kids toothpaste with a fluoride concentration of 1,000 ppm twice a day. Many parents are worried about their young child swallowing or eating fluoride toothpaste and being poisoned. This worry is however unfounded. The German Federal Institute for Risk Assessment (BfR) determined that a child may have an upset tummy at worst after consuming roughly 70 grams, or a whole tube, of children's toothpaste (with a fluoride concentration of 0.05 percent). There is no risk of poisoning.
When can children start using an adult toothpaste?
Actually, children can always use adult toothpaste to brush their teeth – provided the fluoride concentration is right. That said, the typical mint and eucalyptus flavour that adults find pleasantly refreshing is often too intense for young taste buds. We therefore recommend using special children's toothpaste up to the age of twelve, which additionally encourages your child to brush their teeth thanks to the delicious taste.
Good to know:
For a long time, scientists debated the question: "What is better? Fluoride in toothpaste or tablets?". Today, we know that toothpaste is more effective due to its direct contact with the surface of the tooth. However, the most important thing is that you only give your child either fluoride toothpaste or fluoride tablets. If you mean well and use both, your child may suffer a condition called dental fluorosis and develop white lines or flecking on the surface of their teeth. They are particularly susceptible to this condition in the first 24 months.
Encouraging children to brush their teeth correctly: How to do it
Getting your child to brush their teeth is essential, but not necessarily their favourite activity. Discover how to make their daily morning and evening dental hygiene routine as relaxed and fun as possible.
Fun and games when brushing children's teeth
Brushing teeth should never be a struggle or a battle. If you navigate this task with patience, understanding and creativity, you will be able to consciously enjoy the time spent with your child during their dental hygiene routine and experience wonderful moments together at the start of the day and right before bedtime – even if it is bound to be exhausting at times. Here are a few ideas to make toothbrushing with children fun.
Become a storyteller
Children love to hear stories – even when cleaning their teeth. Let your creativity run free and tell a fascinating story when brushing your child's teeth or watching them do it. Here are a few ideas for dental-themed stories:
- A story about nasty bacteria trying to take over the mouth and how a fearless toothbrush comes to the rescue.
- A story about a tooth whose greatest wish is to be clean (just like our hands, feet and faces).
- A story about searching for something precious behind your child's teeth.
- A story about sugar monsters hiding in the mouth that have to be banished.
- A fairytale story about a toothbrush that goes on amazing adventures and meets lots of fascinating characters.
- A story in which your child's favourite cuddly toy tells them why brushing their teeth is so important (place the cuddly toy in front of the mirror and adopt a different voice – this works especially well with very young children).
A time to make silly noises and do silly things
Brushing children's teeth does not have to be all serious and no fun. Make your child laugh and enjoy being silly and having fun.
- Act "goofy" and start brushing your child's ear or tummy with the toothbrush until they correct you and tell you to brush their teeth – this is guaranteed to make them laugh.
- Have a competition with your child to see who can brush their teeth the longest.
- When both parents are present during the toothbrushing routine, your child has the opportunity to brush the teeth of one parent while the other one brushes the child's teeth. If you are alone with your child during the toothbrushing routine, you can let them brush your teeth first. Children love to "help" grown-ups.
Brushing teeth with an entertainment factor
Why should there be dead silence when brushing teeth? Lighten the mood and play your child's favourite song and get them to brush their teeth with you throughout the tune. This ensures that the two to three minutes of toothbrushing fly by.
There are also special dental-themed songs and poems or rhymes that approach the topic of toothbrushing in a playful and child-friendly way and also guarantee two to three minutes of entertainment. You can find an array of songs for brushing your child's teeth on various streaming services and on YouTube, for example. Often these songs come with videos explaining how to brush children's teeth correctly.
If simply listening and watching is not enough, you can go one step further and make the dental hygiene routine child's play with a children's toothbrushing app. There are now various toothbrushing apps that introduce gamification into the bathroom and reward children for brushing their teeth correctly.
Toothbrushing videos do not have to be of professional quality. Children are particularly fascinated if they recognise or actually know the person in the video. For instance, show your child a video of a friend having their teeth brushed.
What to do if brushing your toddler's teeth is a complete disaster?
Even though the aforesaid tips can help turn toothbrushing into a fun family event, there will certainly be days when your child is defiant and refuses point-blank to brush their teeth. That is completely normal and nothing to worry about. However, do not use this as an excuse not to brush their teeth. At the end of the day, it is your responsibility as a parent to make sure your child's teeth are healthy and strong. The only thing you can do is: Stay calm and relaxed yet assertive. When your child realises there is no way around it and that their daily dental hygiene routine is going to happen no matter what, they will simply accept the fact that toothbrushing is part of their daily routine.
But first make sure that you are not hurting your child when brushing their teeth: Use a toothbrush with very soft filaments and a nicely flavoured toothpaste. Also be very careful with the frenulum of the lips: Parents often catch the frenulum when brushing the upper row of teeth, which can be painful for a child. Therefore, lift the lip slightly and be extra careful when brushing your child's teeth.
Insider tip: Use an electric toothbrush
If your child dislikes brushing their teeth, using an electric toothbrush often makes the task easier. Further, children are usually fascinated by the new electronic gadget and more willing to open their mouths – especially if their mummy and daddy also use an electric toothbrush. Important: Remember to make sure that the brush head has soft filaments and is not too big. The Curaprox sonic toothbrushes are ideal for both baby and adult teeth.
Summary: Ten tips for brushing children's teeth correctly
Your head is probably spinning right now after reading all the information about brushing children's teeth correctly. We have therefore summarised the most important tips for you below:
- Start brushing as soon as the first tooth comes through – cavity-causing bacteria do not wait until all the teeth have erupted before launching an attack.
- Use a children's fluoride toothpaste to strengthen the enamel – children under two years of age should use a rice grain-sized amount of toothpaste twice a day, while children from two to six years should brush their teeth three times a day with a pea-sized amount of toothpaste with a fluoride concentration of 1,000 ppm. Children from six years of age can start using toothpaste with a fluoride concentration of 1,450 ppm.
- Always use a soft children's toothbrush with a small brush head.
- When and for how long should you brush teeth? Brush the teeth of children under two years of age twice a day for three minutes each time – in the morning after breakfast and at night before going to bed. Let children from two years of age have a go at brushing their teeth three times a day.
- Until your child can do joined-up handwriting with ease, a parent should follow up at least once a day.
- Do not lick spoons, dummies or drinking bottles before giving them to your child – as there is a risk of transmitting cavity-causing bacteria.
- Leave enough time between meals to allow your child's teeth to remineralise. Sucking on teat bottles full of sugary drinks or prolonged chewing on a pretzel, for example, are bad for your child's teeth.
- Teach your child an easy-to-remember toothbrushing technique, such as the KAI method and later the modified Bass technique, to ensure they do not miss any teeth and develop a good dental hygiene routine.
- As soon as your child has a full set of milk teeth, it is a good idea to clean the spaces between their teeth daily – ideally with an interdental brush.
- Practice makes perfect – be patient with your child while they are learning to brush their teeth correctly. Mishaps are all part and parcel of the learning process.
Frequently asked questions about brushing children's teeth
Below is an overview of some the most frequently asked questions about "brushing children's teeth correctly":
Brushing teeth at nursery school?
While group toothbrushing fosters a culture of health consciousness, it poses challenges in terms of limited resources to effectively monitor each child's brushing technique. Should your child brush their teeth at nursery school?
Our recommendation: Seeing as your child should brush their teeth three times a day anyway, brushing them at nursery school is not a bad idea. Important: Make sure your child can easily recognise their toothbrush and does not mix it up with other toothbrushes – for example, let them choose a toothbrush in a distinctive colour.
Brushing teeth at nursery school offers another major advantage: For children whose parents do not prioritise good dental hygiene, it is a great way for them to learn to brush their teeth regularly.
When should I take my child to the dentist for the first time?
We recommend arranging an appointment to see your dentist after your child's first birthday and taking your child for routine check-ups once a year thereafter. By experiencing routine visits to the dentist, your child will feel that it is a perfectly normal thing to do. Avoid scaring your child unnecessarily and do not just go to the dentist when they are in pain.
At what age can children spit out toothpaste?
Children aged two to three are able to spit out toothpaste or foam. Nevertheless, you should start brushing their teeth with toothpaste as soon as the first milk tooth comes through. In the first two years, we recommend using a zero fluoride toothpaste, as new milk teeth are particularly susceptible to dental fluorosis.
From the age of two, you can start brushing your child's teeth with a fluoride toothpaste without any concerns. Given the very low concentration of fluoride, there is absolutely no risk of poisoning. A rice grain-sized amount of toothpaste is sufficient in the beginning. Start using a pea-sized amount of toothpaste when all the milk teeth have come through. Nevertheless, make sure that your child does not swallow or consume an entire tube of toothpaste. Otherwise, they may suffer an upset tummy.
How often should you replace your child's toothbrush?
Replace your child's toothbrush every three months at the latest or as soon as the filaments start to fray – whichever comes first. Always replace their toothbrush after an oral cavity infection to prevent a new infection from occurring.
Baier, Heike: Zähne putzen bei Kindern: Diese 7 Fehler sollten Eltern vermeiden, at: oekotest.de.
Bayer, Nora et al.: Zähneputzen in der Kita. Pro & Contra, at; herder.de.
Bok, Hye-Jeong et al.: Proper Tooth-Brushing Technique According to Patient’s Age and Oral Status, in: International Journal of Clinical Preventive Dentistry. 2020.
Bundesinstitut für Risikobewertung: Risiko Vergiftungsunfälle bei Kindern.
German Dental Association: Kinder.
German Federal Centre for Health Education: Gesunde Zähne von Anfang an, at: kindergesundheit-info.de.
German Federal Centre for Health Education: Zähneputzen mit KAI – kinderleicht, at: kindergesundheit-info.de.
Dzw: Kinder wollen Zahnhelden.
European Archives of Paediatric Dentistry: Guidelines on the use of fluoride in children:an EAPD policy document.
German National Association of Statutory Health Insurance Physicians (KZBV): Fluoride für Kinder.
German National Association of Statutory Health Insurance Physicians (KZBV): Zähneputzen – rundum sauber.
German National Association of Statutory Health Insurance Physicians (KZBV): Zahnpflege bei Kindern.
Periobasics: Tooth-brushing techniques.
Petrus, Ulrike: Zahnpflege in Kindertagesstätten, at: elterninitiative-prokita.de.
Uhlmann, Ulrike: Zähneputzen bei Kindern: Festhalten, Grenzen setzen und andere Herausforderungen, auf: dentista.de.
Robert Koch-Institut: Mundhygiene und Kariesprophylaxe.
Toumba, K.J. et al.: Guidelines on the use of fuoride for caries prevention in children: an updated EAPD policy document, in: European Archives of Paediatric Dentistry. 2019.
All websites last accessed on 17.04.2023.